Dirt Dash Sign Up Sheet

All fields marked with an * are required

ATTENTION!!!

Stricter enforcement of the rules will be in place from this year forward. No exceptions will be made. If your car/equipment is not within the guidelines of the rules, you WILL be disqualified!

 

Driver Information

*First Name:    *Last Name:    Date of Birth- *Mo:    *Day:    *Year: 

Mailing Address:    City:    State:    Zip Code: 

Daytime Phone:    Evening Phone:    Cell:    *E-mail Address:    *Class: 

Car Information

Vehicle Year:    Vehicle Make:    Vehicle Model:    Number of Cylinders: 

Desired Car Number (ONLY NUMBERS 1 or 2 Digits in length will be accepted)

Be sure to read the new rule!!

*Choice #1:    *Choice #2:    *Choice #3: 

PLEASE READ:

(Car numbers are available on a "first come first served" basis. No guarantee that requested numbers will be available. First choice will be given if not already taken. You will be emailed with your number and also if none of your choices are available. Our scoring assistants are volunteers, not professionals. Different numbers are needed to ease scoring and assure accuracy. )

Sponsor Information

Sponsor #1:    Location: 

Sponsor #2:    Location: 

Sponsor #3:    Location: 

Sponsor #4:    Location: 

Sponsor #5:    Location: 

(Sponsors will be listed and read off by the announcer)

 

 

 

Contact Info

 

Links

 

General Rules

 

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